Provider Demographics
NPI:1770806622
Name:NETTO, JOHN J JR (RPH)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:NETTO
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3128 DENVER DR
Mailing Address - Street 2:
Mailing Address - City:POLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44514-2437
Mailing Address - Country:US
Mailing Address - Phone:330-757-8122
Mailing Address - Fax:
Practice Address - Street 1:3128 DENVER DR
Practice Address - Street 2:
Practice Address - City:POLAND
Practice Address - State:OH
Practice Address - Zip Code:44514-2437
Practice Address - Country:US
Practice Address - Phone:330-757-8122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-07
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03114740183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist